Therapists in Plymouth, MI

Photo of Martha Nacy, Limited Licensed Psychologist in Plymouth, MI
Martha Nacy
Limited Licensed Psychologist, MS, LLP, CAADC
Verified Verified
Plymouth, MI 48170  (Online Only)
Not accepting new clients
Finding a therapist that fits can be a challenge. I offer a respectful relationship to those seeking my counsel. Therapy is a partnership designed to help you to build a better, happier life. I believe we all have courage and strength we don't always recognize. Years of working with others has provided me with extensive knowledge and a wide variety of skills to pass on to you. I primarily utilize CBT and REBT but adapt to whatever my clients respond best to. Together we will tailor the path for change that works best for you. I work with adults and adolescents.
Finding a therapist that fits can be a challenge. I offer a respectful relationship to those seeking my counsel. Therapy is a partnership designed to help you to build a better, happier life. I believe we all have courage and strength we don't always recognize. Years of working with others has provided me with extensive knowledge and a wide variety of skills to pass on to you. I primarily utilize CBT and REBT but adapt to whatever my clients respond best to. Together we will tailor the path for change that works best for you. I work with adults and adolescents.
(734) 228-1729 View (734) 228-1729
Photo of Natalie B Perelli, PhD, PLLC, Psychologist in Plymouth, MI
Natalie B Perelli, PhD, PLLC
Psychologist, PhD, LP
Verified Verified
Plymouth, MI 48170
Everyday life can bring stress and challenges in our families, relationships, work, health and athletic performance. Therapy can be an effective way to help find balance in life and improve your ability to manage these stresses and life challenges.
Everyday life can bring stress and challenges in our families, relationships, work, health and athletic performance. Therapy can be an effective way to help find balance in life and improve your ability to manage these stresses and life challenges.
(734) 228-1681 View (734) 228-1681
Roberta L Martin
Clinical Social Work/Therapist, LMSW, ACSW, CAADC
Verified Verified
Plymouth, MI 48170
I have over 20 years of experience successfully assisting my clients in overcoming internal and external stressors and dysfunction that prevent their overall well-being. These stressors can be situational or life-long struggles, and experienced in interpersonal relationships, in work settings, as mood and or/anxiety disorders, or manifested in issues of self-esteem and self-confidence. I work most often from cognitive-behavioral, psychodynamic, and insight-oriented approaches, understanding that every client is wonderfully unique and will respond differently to a variety of eclectic methodologies. We work together to determine the optimal approach to treatment.
I have over 20 years of experience successfully assisting my clients in overcoming internal and external stressors and dysfunction that prevent their overall well-being. These stressors can be situational or life-long struggles, and experienced in interpersonal relationships, in work settings, as mood and or/anxiety disorders, or manifested in issues of self-esteem and self-confidence. I work most often from cognitive-behavioral, psychodynamic, and insight-oriented approaches, understanding that every client is wonderfully unique and will respond differently to a variety of eclectic methodologies. We work together to determine the optimal approach to treatment.
(734) 259-3575 View (734) 259-3575
Photo of Alyssa Smith, Limited Licensed Psychologist in Plymouth, MI
Alyssa Smith
Limited Licensed Psychologist, LLP
Verified Verified
3 Endorsed
Plymouth, MI 48170  (Online Only)
Welcome, I am Alyssa. You have made a brave step by choosing to seek help, and are on your way towards improving your quality of life. If you are struggling with anxiety or depression related to work, academics, relationships, pregnancy, new parenthood or any other sort of life transition and would like someone to help you find your way through these moments I am here to help. If you have been wondering why you feel the way that you do, I will work with you to help unpack the nature of these concerns and find a way towards understanding and peace.
Welcome, I am Alyssa. You have made a brave step by choosing to seek help, and are on your way towards improving your quality of life. If you are struggling with anxiety or depression related to work, academics, relationships, pregnancy, new parenthood or any other sort of life transition and would like someone to help you find your way through these moments I am here to help. If you have been wondering why you feel the way that you do, I will work with you to help unpack the nature of these concerns and find a way towards understanding and peace.
(734) 215-9063 View (734) 215-9063
Photo of Ryleigh Strong, Clinical Social Work/Therapist in Plymouth, MI
Ryleigh Strong
Clinical Social Work/Therapist, LLMSW
Verified Verified
1 Endorsed
Plymouth, MI 48170
I treat anxiety and trauma by helping clients understand the root cause of, and replace maladaptive coping skills such as perfectionism and addiction with healthy coping skills. I also am passionate about enhancing relationships through couples counseling and parent coaching.
I treat anxiety and trauma by helping clients understand the root cause of, and replace maladaptive coping skills such as perfectionism and addiction with healthy coping skills. I also am passionate about enhancing relationships through couples counseling and parent coaching.
(734) 807-3713 View (734) 807-3713
Photo of Kenneth D. Whittum, Counselor in Plymouth, MI
Kenneth D. Whittum
Counselor, MA, LPC
Verified Verified
4 Endorsed
Plymouth, MI 48170
If you're struggling in a relationship, with a particular issue, or just don't feel like yourself anymore, therapy may be right for you. Here you'll find a relaxed and empathetic environment where you can safely identify and explore those issues that may be getting in the way of you experiencing a more fulfilling life or relationship. My goal is to not merely treat the symptom, but help you understand the underlying cause of it. So for instance, not just minimize the behavioral display of anger, anxiety or depression, or whatever the concern is, but help you understand why you're so prone to experiencing it. The result is that you'll become much more empowered to live and feel the way you want. And, you'll inevitably become more confident in dealing with your present concerns in a way that will make lasting positive change.
If you're struggling in a relationship, with a particular issue, or just don't feel like yourself anymore, therapy may be right for you. Here you'll find a relaxed and empathetic environment where you can safely identify and explore those issues that may be getting in the way of you experiencing a more fulfilling life or relationship. My goal is to not merely treat the symptom, but help you understand the underlying cause of it. So for instance, not just minimize the behavioral display of anger, anxiety or depression, or whatever the concern is, but help you understand why you're so prone to experiencing it. The result is that you'll become much more empowered to live and feel the way you want. And, you'll inevitably become more confident in dealing with your present concerns in a way that will make lasting positive change.
(734) 606-4096 View (734) 606-4096
Photo of Brett Karpack, Psychologist in Plymouth, MI
Brett Karpack
Psychologist, MS, TLLP
Verified Verified
1 Endorsed
Plymouth, MI 48170
My goal is to work with you to be the best version of yourself. I treat everyone as an individual, and our plan together will be specific to your needs. I like to stay open-minded and non-judgmental, and I see you as the expert on your own experiences and feelings. I have treated a variety of clients from a diverse range of backgrounds, and I am ready to address any obstacles you might be facing. I am prepared to use a variety of techniques and therapeutic approaches, all of which start with building a relationship based on trust and understanding.
My goal is to work with you to be the best version of yourself. I treat everyone as an individual, and our plan together will be specific to your needs. I like to stay open-minded and non-judgmental, and I see you as the expert on your own experiences and feelings. I have treated a variety of clients from a diverse range of backgrounds, and I am ready to address any obstacles you might be facing. I am prepared to use a variety of techniques and therapeutic approaches, all of which start with building a relationship based on trust and understanding.
(734) 749-9618 View (734) 749-9618
Photo of Connie Calderon Kretschmer, Clinical Social Work/Therapist in Plymouth, MI
Connie Calderon Kretschmer
Clinical Social Work/Therapist, LMSW
Verified Verified
Plymouth, MI 48170
My goal is to empower you to become your own agent of change and provide a non-judgmental/supportive environment to do so. I have worked with a wide variety of clients ranging from Individuals with chronic mental illness to corporate coaching. They have one thing in common, the courage to begin the therapeutic journey to heal and grow. I view therapy as a collaborative process and we will work together to identify your strengths, uncover patterns and develop tools to overcome obstacles. Some clients dive right in, some clients call me from the parking lot riddled with fear. We will start wherever you need to.
My goal is to empower you to become your own agent of change and provide a non-judgmental/supportive environment to do so. I have worked with a wide variety of clients ranging from Individuals with chronic mental illness to corporate coaching. They have one thing in common, the courage to begin the therapeutic journey to heal and grow. I view therapy as a collaborative process and we will work together to identify your strengths, uncover patterns and develop tools to overcome obstacles. Some clients dive right in, some clients call me from the parking lot riddled with fear. We will start wherever you need to.
(734) 888-9117 View (734) 888-9117
Photo of Hannah Cross Getto Abdelhady, Clinical Social Work/Therapist in Plymouth, MI
Hannah Cross Getto Abdelhady
Clinical Social Work/Therapist, LLMSW
Verified Verified
1 Endorsed
Plymouth, MI 48170
I love working with children and families. I want to have clear communication with guardians while also creating a safe space that allows children to express themselves with a degree of age-appropriate privacy. I work with children to identify their emotions, learn their emotional triggers, and build a toolkit of coping skills. I also work with you as guardian to build plans of action at home and provide psychoeducation that is research backed so that you feel informed and confident in your parenting. I also recognize that as your family grows and changes you may find it helpful to reach out for support for yourself.
I love working with children and families. I want to have clear communication with guardians while also creating a safe space that allows children to express themselves with a degree of age-appropriate privacy. I work with children to identify their emotions, learn their emotional triggers, and build a toolkit of coping skills. I also work with you as guardian to build plans of action at home and provide psychoeducation that is research backed so that you feel informed and confident in your parenting. I also recognize that as your family grows and changes you may find it helpful to reach out for support for yourself.
(734) 749-8550 View (734) 749-8550
Photo of Nannette Gottfried, Clinical Social Work/Therapist in Plymouth, MI
Nannette Gottfried
Clinical Social Work/Therapist, LMSW, ACSW
Verified Verified
Plymouth, MI 48170
Not accepting new clients
Life has many dilemmas, but at the same time, we have the strength to thrive, when supported through an engaging, therapeutic relationship. Through collaboration and insight, I will help you develop new skills and meaningful and lasting changes to achieve your dreams and aspirations. Specialties include depression and anxiety, relationship/family conflict, suicidal thoughts and self-harm, trauma and PTSD, grief and loss, aging, caregiver stress, work issues, anger management, LGBTQ, infertility and pregnancy, ADHD, life transitions, parenting, divorce, coping skills, abuse (physical, sexual, and emotional), and illness management.
Life has many dilemmas, but at the same time, we have the strength to thrive, when supported through an engaging, therapeutic relationship. Through collaboration and insight, I will help you develop new skills and meaningful and lasting changes to achieve your dreams and aspirations. Specialties include depression and anxiety, relationship/family conflict, suicidal thoughts and self-harm, trauma and PTSD, grief and loss, aging, caregiver stress, work issues, anger management, LGBTQ, infertility and pregnancy, ADHD, life transitions, parenting, divorce, coping skills, abuse (physical, sexual, and emotional), and illness management.
(734) 228-1086 View (734) 228-1086
Photo of Jill Kovach, Psychologist in Plymouth, MI
Jill Kovach
Psychologist, PsyD
Verified Verified
Plymouth, MI 48170
Within the relationships that I build with individuals, I work to meet them where they are at and grow from there. My approach is being open, empathetic, and relational as that allows for us to develop trust in working through some of life's most delicate moments. Whether these moments are processed through creative modalities, such as art and play, or by being able to talk, process, or seek guidance, I try to ensure trust is built as a cornerstone of our relationship. It is important to me that individuals feel safe in exploring thoughts, feelings, and behaviors within our therapeutic space.
Within the relationships that I build with individuals, I work to meet them where they are at and grow from there. My approach is being open, empathetic, and relational as that allows for us to develop trust in working through some of life's most delicate moments. Whether these moments are processed through creative modalities, such as art and play, or by being able to talk, process, or seek guidance, I try to ensure trust is built as a cornerstone of our relationship. It is important to me that individuals feel safe in exploring thoughts, feelings, and behaviors within our therapeutic space.
(734) 440-9342 View (734) 440-9342
Photo of Prime Counseling Services , Clinical Social Work/Therapist in Plymouth, MI
Prime Counseling Services
Clinical Social Work/Therapist, LLMSW
Verified Verified
Plymouth, MI 48170
Not accepting new clients
Do you often feel misunderstood by others or sometimes struggle to understand yourself? Do you feel pressure to be someone you’re not or find it hard to express yourself authentically? Taking this first step towards change and healing is often one of the most intimidating parts of the therapeutic process, so I first want to say, welcome – I’m so glad you’re here. I specialize in working with adults experiencing anxiety, depression, complex trauma, emotional dysregulation, low self-esteem, and life transitions seeking to reconnect with themselves and create more meaningful relationships with those around them.
Do you often feel misunderstood by others or sometimes struggle to understand yourself? Do you feel pressure to be someone you’re not or find it hard to express yourself authentically? Taking this first step towards change and healing is often one of the most intimidating parts of the therapeutic process, so I first want to say, welcome – I’m so glad you’re here. I specialize in working with adults experiencing anxiety, depression, complex trauma, emotional dysregulation, low self-esteem, and life transitions seeking to reconnect with themselves and create more meaningful relationships with those around them.
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Photo of Alexis Ashby, Clinical Social Work/Therapist in Plymouth, MI
Alexis Ashby
Clinical Social Work/Therapist, LMSW
Verified Verified
Plymouth, MI 48170
It is my belief that our lives really are what we make of them. I want to help you find all the peace and beauty out there and most importantly within you. You are capable. You are resilient. You are worthy.
It is my belief that our lives really are what we make of them. I want to help you find all the peace and beauty out there and most importantly within you. You are capable. You are resilient. You are worthy.
(734) 304-5125 View (734) 304-5125
Photo of Hasti Raveau, Psychologist in Plymouth, MI
Hasti Raveau
Psychologist, PhD, LP
Verified Verified
9 Endorsed
Plymouth, MI 48170
Dr. Raveau is a clinical psychologist and founder of Mala Child & Family Institute. She is an expert in treating ADHD/neurodiversity, trauma/PTSD, anxiety/OCD/perfectionism, parenting/co-parenting issues, racial minorities, and family level challenges. She helps clients end intergenerational cycles of trauma, form authentic relationships, embrace their neurodiversity and cultural background, and build authentic lives filled with a sense of abundance and inner peace. Dr. Raveau embraces working with individuals and families who identify with a range of ethnicities, religions, sexual orientations, and gender identities.
Dr. Raveau is a clinical psychologist and founder of Mala Child & Family Institute. She is an expert in treating ADHD/neurodiversity, trauma/PTSD, anxiety/OCD/perfectionism, parenting/co-parenting issues, racial minorities, and family level challenges. She helps clients end intergenerational cycles of trauma, form authentic relationships, embrace their neurodiversity and cultural background, and build authentic lives filled with a sense of abundance and inner peace. Dr. Raveau embraces working with individuals and families who identify with a range of ethnicities, religions, sexual orientations, and gender identities.
(734) 245-2279 View (734) 245-2279
Photo of Andrea Morrison, Psychologist in Plymouth, MI
Andrea Morrison
Psychologist, PsyD
Verified Verified
3 Endorsed
Plymouth, MI 48170
Hi my name is Dr. Andrea Morrison. I have over 20 years experience helping people with a multitude of concerns and worries. I have been a Licensed Psychologist for 17 years first with my masters then obtaining my Doctorate. When you are filling out a checkbox for what you are looking for in a therapist or a client it is ironic to me. I have always been person-centered with a solution-focused approach. My main approach is CBT but EACH person is unique in their needs. I meet them where they are, learn where they want to be and tailor the treatment goals in that manner. In that sense, I am eclectic and diverse in my approach.
Hi my name is Dr. Andrea Morrison. I have over 20 years experience helping people with a multitude of concerns and worries. I have been a Licensed Psychologist for 17 years first with my masters then obtaining my Doctorate. When you are filling out a checkbox for what you are looking for in a therapist or a client it is ironic to me. I have always been person-centered with a solution-focused approach. My main approach is CBT but EACH person is unique in their needs. I meet them where they are, learn where they want to be and tailor the treatment goals in that manner. In that sense, I am eclectic and diverse in my approach.
(248) 247-7417 View (248) 247-7417
Photo of Hadley Huff, Clinical Social Work/Therapist in Plymouth, MI
Hadley Huff
Clinical Social Work/Therapist, LLMSW
Verified Verified
3 Endorsed
Plymouth, MI 48170
As a therapist, I enjoy working with people from all walks of life. I believe anyone can benefit from therapy. During my sessions, I love helping people discover their authentic self, cultivating a safe space where clients feel comfortable, and giving them the tools to deal with the problems they face each day. I desire to help people have healthier relationships, overcome negative emotions, and experience a more full and free life.
As a therapist, I enjoy working with people from all walks of life. I believe anyone can benefit from therapy. During my sessions, I love helping people discover their authentic self, cultivating a safe space where clients feel comfortable, and giving them the tools to deal with the problems they face each day. I desire to help people have healthier relationships, overcome negative emotions, and experience a more full and free life.
(734) 519-6778 View (734) 519-6778
Photo of Renee Bryer, Psychologist in Plymouth, MI
Renee Bryer
Psychologist, PhD, ABPP-CN, HSPP
Verified Verified
Plymouth, MI 48170
At some point in life's journey, we are confronted with a situation or experience that is difficult to manage. This difficulty may stem from unforeseen life circumstances or our inability to cope effectively with the expected. Seeking professional help to better understand ourselves and our situation can provide the window of opportunity for a better quality of life. This improved quality of life may include a healthier lifestyle, a smoother adjustment to a life change, more rewarding relationships, improved school performance, or a more gratifying career.
At some point in life's journey, we are confronted with a situation or experience that is difficult to manage. This difficulty may stem from unforeseen life circumstances or our inability to cope effectively with the expected. Seeking professional help to better understand ourselves and our situation can provide the window of opportunity for a better quality of life. This improved quality of life may include a healthier lifestyle, a smoother adjustment to a life change, more rewarding relationships, improved school performance, or a more gratifying career.
(734) 206-7306 View (734) 206-7306
Photo of Lauren Waters, Clinical Social Work/Therapist in Plymouth, MI
Lauren Waters
Clinical Social Work/Therapist, LLMSW-C
Verified Verified
7 Endorsed
Plymouth, MI 48170
Maya Angelou famously wrote, “My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.” Let’s collaborate as co-authors of the life you want to live. You’re the expert on your story, and within our sessions we can translate that into the changes you’re looking for. Together, we can approach whatever chapter you’re in with new eyes, fresh strategy, and a little humor.
Maya Angelou famously wrote, “My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humor, and some style.” Let’s collaborate as co-authors of the life you want to live. You’re the expert on your story, and within our sessions we can translate that into the changes you’re looking for. Together, we can approach whatever chapter you’re in with new eyes, fresh strategy, and a little humor.
(734) 259-6153 View (734) 259-6153
Photo of Lauren Ruttenberg, Clinical Social Work/Therapist in Plymouth, MI
Lauren Ruttenberg
Clinical Social Work/Therapist, LLMSW
Verified Verified
1 Endorsed
Plymouth, MI 48170
I know the first step in therapy can be intimidating, but I am here to help you feel comfortable in the process. My goal for our sessions is to create space for you to receive support that meets your needs while helping you to reach your full potential. Trust and safety with my clients are my number one priority.
I know the first step in therapy can be intimidating, but I am here to help you feel comfortable in the process. My goal for our sessions is to create space for you to receive support that meets your needs while helping you to reach your full potential. Trust and safety with my clients are my number one priority.
(248) 648-3244 View (248) 648-3244
Photo of Journey Together, PC, Psychologist in Plymouth, MI
Journey Together, PC
Psychologist, PsyD
Verified Verified
2 Endorsed
Plymouth, MI 48170
Therapy is an opportunity for you to learn about yourself and make the changes you want or need to make emotionally, cognitively, relationally or behaviorally. It is an art that must be tailored to each person. Our job as your therapist is to create an environment to help you grow and actively seize opportunities to make different choices and write your own story. We use person-centered approach which includes empathy, active listening, and honest feedback. We're careful not to make choices for you, but help you learn to make them for yourself.
Therapy is an opportunity for you to learn about yourself and make the changes you want or need to make emotionally, cognitively, relationally or behaviorally. It is an art that must be tailored to each person. Our job as your therapist is to create an environment to help you grow and actively seize opportunities to make different choices and write your own story. We use person-centered approach which includes empathy, active listening, and honest feedback. We're careful not to make choices for you, but help you learn to make them for yourself.
(734) 749-8718 View (734) 749-8718

How does your Therapist compare?

Number of Therapists in Plymouth, MI

300+

Average cost per session

$150

Therapists in Plymouth, MI who prioritize treating:

94% Anxiety
90% Depression
81% Self Esteem
75% Relationship Issues
73% Coping Skills
73% Stress
66% Trauma and PTSD

Average years in practice

11 Years

Top 3 insurances accepted

98% BlueCross and BlueShield
64% Blue Care Network
49% Aetna

How Therapists in Plymouth, MI see their clients

78% In Person and Online
22% Online Only

Gender breakdown

81% Female
17% Male
2% Non-Binary
FAQs - About Therapy and Counseling

How can I find a therapist in Plymouth?

Search for nearby therapists or counselors by inputting your city, town, or suburb; or zip code; or a provider’s name into the search bar. From there, you can filter providers by the issues they treat, cost, insurance, gender, and other factors to find providers who are well-suited to your needs. To navigate between locations within the same country, enter a new city or zip code into the search bar.

Learn more about how to find a therapist

Is everyone in the Psychology Today Therapy Directory a licensed therapist?

The Psychology Today directory lists providers who offer legitimate mental health services to the public, including psychologists, psychiatrists, social workers, and counselors.

Many have been licensed by the country or state where they practice; providers whose license or primary credential has been verified by Psychology Today are signified by a “Verified” symbol. Some clinicians or organizations provide services for which their state or country does not offer licenses, such as pastoral counseling. They may be selectively included without the “Verified” seal.

What’s the difference between a psychologist, a therapist, and a counselor?

Therapists, psychologists, and counselors are all licensed mental health professionals. In the US, psychologists have earned a doctoral degree. The terms “therapist” and “counselor” are used somewhat interchangeably, but generally therapists offer longer-term, mental health care, while counselors offer shorter-term care that may focus on one domain, such as marriage, career, or academic challenges.

Clients should consider factors such as insurance coverage and their primary reason(s) for seeking therapy to determine the type of professional best suited to their needs. Someone struggling with mental health challenges such as depression or anxiety, for example, may wish to seek out a clinical psychologist or therapist, while someone navigating career obstacles or marital upheaval may benefit from seeing a counselor who can offer short-term, targeted support.

What type of therapy is right for me?

The type of therapy best suited to a particular individual depends on several factors, including their primary reason for seeking therapy, their preferred timeline (some therapy types last for a set number of sessions, while others are open-ended), and their personality and preferences—some may prefer a more structured approach. For many individuals, multiple types of therapy could provide a good fit.

How much does therapy cost?

The cost of therapy depends on a number of variables, including location and the therapist’s experience and training. On average, a therapy session in the United States could cost between $100 and $200 or more. If you have insurance, the expense of mental health care is typically lower, but it varies based on your insurance plan details and whether you choose an in-network or out-of-network mental healthcare provider.

What are more affordable or low cost therapy solutions?

Many therapists offer sliding scale payments, usually on a limited number of slots, which consists in an agreement between the therapist and a client to pay a reduced rate. Therapists who provide such arrangements often consider the client's income or ability to pay, but the extent of the discount is ultimately at the therapist's discretion. Furthermore, while group therapy may have different goals and benefits compared to individual therapy, it can be a more affordable solution to address certain types of issues.

Is online therapy cheaper than in-person therapy?

Many therapists charge the same amount for online therapy as they do for in-person therapy—though clients may still find this cost-effective if it cuts down on their transportation costs. Health insurance plans often offer equivalent coverage for online and in-person therapy; indeed, in many places, they are legally required to do so. Text-based or on-demand therapy apps may be cheaper than traditional one-on-one psychotherapy; however, the practice may be less effective and is not likely to be covered by insurance.

Is online therapy a good option?

Therapy conducted online can be just as effective as in-person therapy, as long as there is a strong alliance between the client and the therapist. To find a therapist who provides telehealth services to clients in your area, click “Online Therapy” on the directory homepage and search by your city or town or your zip code.

Are therapy sessions confidential?

Confidentiality is a crucial part of the therapeutic relationship. Therapists in the United States are bound by the regulations set out by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which aims to protect sensitive health information. With very few exceptions, a therapist will only discuss their client with others when the client has given their written permission. The instances in which a therapist would be required to disclose personal information are: if a client poses a danger to themselves or others, if the therapist suspects the abuse of a child or an elderly or otherwise dependent adult, or if they are legally forced to by court order. These exceptions to the confidentiality agreement are usually discussed with a client before their first session.